降糖精治疗早期糖尿病肾病患者的疗效及其对尿微量白蛋白的影响  

Effect of Jiangtangjing granule on early diabetic nephropathy and its influence on urinary microalbumin

作　　者：薛莉[1] 袁艳娟[1] 苏敏[1] XUE Li;YUAN Yan-juan;SU Min(Department of Renal Endocrinology,Nantong Hospital of Traditional Chinese Medicine,Nantong,Jiangsu 226001,China)

机构地区：[1]南通市中医院肾脏内分泌科

出　　处：《中国临床研究》2018年第12期1624-1627,共4页Chinese Journal of Clinical Research

摘　　要：目的探讨降糖精对早期糖尿病肾病(DN)患者疗效及尿微量白蛋白(UMA)的影响。方法连续选择2016年8月至2017年9月明确诊断DN的患者42例,随机分为对照组与观察组,每组各21例。对照组予以降糖、降压等常规西医治疗,观察组在对照组治疗基础上联合南通市中医院自制制剂降糖精(批准文号:苏药制字Z04001366,含黄芪、制黄精、薏苡仁、葛根、山药、生山楂、水蛭、白芥子等)治疗,每日3次,每次10 g,温水冲服。两组疗程均为8周。分别观察两组患者治疗前后UMA、尿β2微球蛋白(β2-MG)、血尿素氮(BUN)及血肌酐(SCr)等指标变化情况。并结合患者临床症状及体征改善情况评价不同方案间疗效的差异。此外,分别观察两组患者药物相关不良反应发生情况以评价其安全性。结果观察组患者治疗总有效率为85. 71%,较对照组(66. 67%)略有升高,但差异无统计学意义(P>0. 05)。治疗前两组患者中医症候积分无统计学差异(P>0. 05),治疗后2、4、8周,两组患者中医症候积分比治疗前明显下降,且观察组低于对照组(P<0. 05)。治疗前两组患者残余肾功能(RRF)和尿量无统计学差异(P>0. 05);治疗后,两组患者RRF和尿量均比治疗前明显下降(P<0. 01),且对照组低于观察组(P<0. 05,P<0. 01)。治疗后,两组患者的UMA、β2-MG、BUN水平较治疗前均有显著下降,且观察组患者UMA及β2-MG水平较对照组显著降低,差异有统计学意义(P<0. 05)。两组患者药物相关不良反应发生率间未见统计学差异(P>0. 05)。两组患者治疗过程中均未见明显药物相关不良反应发生。结论降糖精颗粒可显著提高早期DN患者的临床疗效,并能降低患者UMA、β2-MG及BUN水平,且用药过程安全性良好。Objective To investigate the influences of Jiangtangjing granule on the curative effect of early diabetic nephropathy（ DN） and on urinary microalbumin（ UMA）. Methods Forty-two patients with confirmed DN from August2016 to September 2017 were selected and randomly divided into control group and observation group（ n = 21,each）. The routine western medicine such as hypoglycemia and hypotension was given in control group,and the Jiangtangjing granule[self-made preparations of Nantong Hospital of Traditional Chinese Medicine,approval number: Z04001366,containing Huangqi（ Astragalus propinquus）,Huangjing（ Polygonatumsibiricum）,Yiyi（ Coixlacryma-jobi seed）,Gegen（ Pueraria lobata root）,Shanyao（ Dioscoreapolystachya）,Shanzha（ Crataeguscuneata）,Shuizhi（ Hirudomedicinalis） and Baijiezi（ Sinapis alba seed） ]was added in observation group based on the routine treatment. All patients took medicine 3 times a day,10 g each time with warm water for 8 weeks in both two groups. The change in the levels of UMA,urinary beta-2-microglobulin（ β2-MG）,blood urea nitrogen（ BUN） and serum creatinine（ SCr） were observed before and after treatment;the difference of curative effect was evaluated based on the improvement of clinical symptoms and signs; the incidence of adverse drug reactions（ ADR） was observed to evaluate their safety in two groups. Results The total effective rate was85. 71% in observation group and 66. 67% in control group,but there was no statistical difference（ P > 0. 05）. Before treatment,there was no significant difference in Traditional Chinese Medicine（ TCM） syndrome scores between two groups（ P>0. 05）. After 2-,4-and 8-week of treatment,TCM symptom scores decreased significantly compared with those before treatment in both two groups,and they were significantly lower in observation group than those in control group（ all P<0.05）. Before treatment,there were no significant differences in residual renal function（ RRF） and urine volume betwee

关 键 词：糖尿病肾病 尿微量白蛋白 降糖精 安全性 

分 类 号：R587.2[医药卫生—内分泌]